Intraarticular pressure during operation of cervical hip fractures

Jacobsson, Bo; Dalén, Nils; Jönsson, B; Ackerholm, Per

doi:10.3109/17453678809149336

Cited by 12 publications

(2 citation statements)

References 13 publications

(13 reference statements)

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“…13 In addition, any articular disruption will subject the subchondral bone of the femoral head to the pressure of a haemarthrosis; this has been recognised as a potential factor for necrosis. [14][15][16][17] This may also apply to breaching of the posterior cortex of the femoral neck, and there is also the possibility of damage to the posterior circumflex artery. It therefore seems probable that in the osteosynthesis of Garden type-I fractures of the femoral neck, independent of the initial trauma, intra-articular penetration and posterior cortical breaching increase the risk of avascular necrosis.…”

Section: Gardenmentioning

confidence: 99%

Articular Penetration Is More Likely in Garden-I Fractures of the Hip

Hernigou

Besnard

1997

The Journal of Bone and Joint Surgery. British volume

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Plain radiographs show only two dimensions of a three-dimensional object. On anteroposterior and lateral radiographs an implant may appear to be safely within the head of the femur although surface penetration has occurred. We have attempted to identify this complication in the treatment of fractures of the femoral neck and have analysed the position of a screw or pin in the femoral head and neck on the basis of orthogonal frontal and lateral radiographs. A retrospective analysis of 60 cases of osteosynthesis of fractures of the femoral neck confirmed the risk of non-recognition of articular penetration or breaking of the cortex of the neck during surgery. Unrecognised screw penetration of the hip was observed in 8% and of the posterior part of the neck in 10%. The risk differs according to the type of fracture: it is greater in the coxa valga produced by Garden-I fractures of the femoral neck.

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Section: Gardenmentioning

confidence: 99%

Articular Penetration Is More Likely in Garden-I Fractures of the Hip

Hernigou

Besnard

1997

The Journal of Bone and Joint Surgery. British volume

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“…15 In addition, articular disruption subjects the subchondral bone of the femoral head to the pressure of a hemarthrosis, which is a potential risk factor for osteonecrosis. 16,17 Therefore, the current accepted technique involves placing the screws as close as possible to the subchondral bone, taking care to avoid having the screw enter the joint.…”

mentioning

confidence: 99%

Multiple Radiographic Projections in Detecting Intra-articular Screw Penetration During Fixation of Femoral Neck Fractures

Zhang¹,

Guo²,

Gao³

et al. 2014

Orthopedics

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The authors performed a cadaveric study to evaluate the efficacy of multiple fluoroscopic projections in detecting intra-articular penetration of the screws during femoral neck fracture fixation and also to determine the most suitable radiographic projection. Models of intra-articular penetration in 8 normal proximal femur specimens were created by placing the pins in different quadrants of the femoral head and extending 1 mm beyond the femoral head surface. The tip-to-surface distance was measured on anteroposterior (AP) and lateral views, with the femur positioned at varying degrees of rotation, flexion, adduction, and abduction. After correcting for differences in magnification, associations between the tip-to-surface distance and femur position were noted. In certain femur positions and K-wire placements, conventional AP and lateral views did not show that the wire extended beyond the surface of the femoral head. The tip-to-surface distance on an AP radiograph with the femur in the neutral position was not comparable to that on the lateral view with the femur positioned at 20° of adduction (P=.821). However, the tip-to-surface distance on an AP radiograph with the femur in the neutral position varied significantly (P<.001) from all other tip-to-surface distances on either the AP or lateral projection. A linear association was found between the tip-to-surface distance and femur rotation angles on AP views and between femur adduction and abduction angles on lateral views. In conclusion, fluoroscopy in varied projections at different angles can detect unrecognized intra-articular screw penetration during internal fixation of femoral neck fracture. Additional special projection methods are suggested to identify and prevent intra-articular screw penetration.

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Internal fixation implants for intracapsular hip fractures in adults

Parker

Gurusamy

2001

Cochrane Database of Systematic Reviews

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Intraarticular pressure during operation of cervical hip fractures

Cited by 12 publications

References 13 publications

Articular Penetration Is More Likely in Garden-I Fractures of the Hip

Articular Penetration Is More Likely in Garden-I Fractures of the Hip

Multiple Radiographic Projections in Detecting Intra-articular Screw Penetration During Fixation of Femoral Neck Fractures

Internal fixation implants for intracapsular hip fractures in adults

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